The surgical schedule is packed today and all 8 surgical suites will be operating from 7 AM to 7 PM.

Operating Room #1

In operating room #1 is Dr. John Q, is a distinguished orthopedic surgeon, having a Mayo Clinic degree and many published papers. There are no complaints at the State Medical Board regarding Dr. John Q.

Using an advanced endoscope, he will operate on six arthritic knees today to investigate the origin of chronic knee pain. He will simply squirt water into the joint, irrigate it out, and close up the surgical wound. Each operation takes no longer than 20 minutes.

Weight loss, physical therapy, pain medications, injection of viscous lubricants, oral hyaluronic acid, all alternatives to surgery, were not offered to any of these patients as options, at least not until the operation was over.

This procedure has been called “the five-thousand dollar operation you don’t need.” None of these six operated patients experience pain relief after surgery. Controlled studies indicate this type of operation is needless. The hospital orthopedic committee, the surgical oversight committee, the County medical society and the State Medical Board say nothing.

Operating Room #2

In operating room #2 Dr. Ben G. will place stents (wire props) in coronary arteries of three patients with chronic chest pain.

Even though stents do not address the cause of the chest pain and they pose a risk in themselves (they can collapse and cause sudden death), and studies indicate many stenting operations could be avoided by use of medication, this practice continues unabated.

Dr. Ben G. will be writing a case report for a medical journal about his patient receiving his 5th stent. Dr. Ben G. is known as a renowned cardiac surgeon.

Operating Room #8

In operating room #8 Dr. Manfred V. will remove both healthy breasts from a fearful 28-year old woman who recently discovered she has a high-risk for future breast cancer and whose mother died of the disease at any early age. The doctor vehemently advocates the decision to operate on patients like these rests between the patient and doctor and no outside interference should take place.

Operating Room #3

Dr. Joseph H. is removing the thyroid gland from a middle-aged patient with an abnormal nodule that was recently detected. This will be the 37th thyroidectomy he will have performed this year. He regularly lectures on advances in this type of surgery.

Eye outpatient clinic

Over in the ophthalmology clinic out-patient department a dozen patients with wet macular degeneration will undergo direct needle injection of a medication that causes abnormal blood vessels to recede at the back of the eye.

This condition is known as wet macular degeneration. Dr. Mack Z. is the retinal specialist. He is well regarded and is esteemed by his patients. His gentle hands make the injection as painless as possible.

Retinal specialists make over $1000 per patient for a 1-minute procedure. The injections have to be done every 4-6 weeks to save the patients’ sight. The lack of oxygen at the back of the eyes triggers formation of new blood vessels that invade the visual center of the eye (the macula). Two drug companies now sell over $1 billion of the drug used to treat this disease. Each dose costs ~$1500. The drug was being sold as a cancer drug and an equivalent dose cost $50. So the drug is massively over-priced.

The treatment is not successful for about 15% of the patients and an oral dietary supplement that appears to be effective in these cases is ignored as it represents a potential threat to the income stream eye doctors now generate by injecting this medicine. Eye doctors are no longer protecting their patients’ vision, they are protecting their incomes.

The bottom line

Bilking insurance has become so common that the entire health care system is now dependent upon it. Now, should the systemic epidemic of needless care be remedied, whole hospital chains would collapse, medical device companies would fold and hundreds of thousands of hospital and ancillary health care workers would be without work. But hundreds of billions of healthcare dollars would be saved. The Congressional Budget Office says that up to 30 percent of the health care in the U.S. is unnecessary.

Doctors stand as traditional protectors between patients and the medical care industry. They have given themselves over to the other side. Who will stop them? Any attempt to put a stop to this is deemed to be an interference with the doctor-patient relationship. Doctors also often characterize efforts to halt unnecessary care as “rationing care.” The end of fee-for-service medical care would help. Doctors should be placed on salary like in other countries if they cannot police themselves.